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Dentin deformation after scratching with clinically-relevant forces.

OBJECTIVE: In order to understand the mechanism of dentin sensitivity to tactile stimuli, the purpose of this study was to evaluate possible permanent deformation of dentin produced by scratching dentin surfaces with clinically-relevant forces. METHODS: Midcoronal dentin was prepared from twenty human teeth and polished to 4000-grit and ultrasonicated. The dentin surface of each specimen was scratched under forces ranging from 30 to 100 centi-Newtons (cN). The depth of the grooves were measured with a profilometer and the overall hardness of dentin in the vicinity of the grooves was measured. Additional dentin specimens were prepared for SEM evaluation. RESULTS: Dentin hardness was constant and no statistical difference was found among the specimens. Statistically significant differences in groove width and depth were found when increasing force was applied to the dental explorer tip. The depth of the groove ranged from 0.21+/-0.09 microm for the 30 cN group to 1.27+/-0.39 microm for the 100 cN group. The width of the groove ranged from 19.3+/-4.0 microm for the 30 cN group to 43.0 microm for the 10 0 cN group. CONCLUSIONS: (1). The threshold force necessary to create scratches in dentin with a dental explorer was 30 cN or a compressive stress of 1003 MPa. As this exceeds the crushing strength of dentin, this force produces plastic deformation of dentin; (2). Theoretical calculations indicated that even the highest scratching forces (100 cN) could not induce sufficient fluid flow to activate pulpal mechanoreceptors, although it could induce sufficient elastic deformation to theoretically shift dentinal fluid at a rate sufficient to activate mechanoreceptors; (3). The results of this work may lend support the hydrodynamic theory in that scratching of dentin surfaces causes both elastic and plastic deformation of dentin that may displace dentinal fluid toward the pulp where it could activate mechanoreceptors.

Dentin↗

Dentin-predentin complex and its permeability: pathology and treatment overview.

This review paper focuses attention on tissue changes which may take place in dentin and on localized alterations in tissue formation in the predentin area. A number of reaction patterns has been described in dentin affecting both the inorganic and organic components. Dentinal tubules may become partly or completely obturated by growth of the peritubular dentin. Precipitation of mineral salts within the tubules, which may be a reprecipitation of minerals from adjacent demineralized dentin, represents a fundamentally different mode of obturation of dentinal tubules. Initially, demineralization selectively affects the peritubular dentin. If dentin is exposed to the oral environment, the surface layer may become hypermineralized. The surface layer of dentin, exposed by grinding, becomes covered by a smear layer. Displacement of the contents of the tubules or of the odontoblasts is a characteristic change in the organic components. Odontoblast destruction or degeneration will lead to a lack of, or reduced, predentin formation. Changes in the protein components which lead to alterations in dentin permeability have also been reported. The structure of the interface between dentin and localized formations of irregular secondary dentin varies considerably. If there is no tubular communication between primary and secondary dentin, the interface will act as an impermeable barrier. Changes in dentin, including irregular secondary dentin formation, affect the permeability of the tissue. Such changes are clinically important for the outcome of all types of restorative work performed on vital teeth.

Adult↗

Influence of human tooth cryopreservation on dentin bond strength.

OBJECTIVES: The goal of this study was to evaluate the effects of cryopreservation of teeth on dentin bond strength as a function of remaining dentin thickness. METHODS: Flat occlusal surfaces of human dentin were prepared in 54 freshly extracted teeth and 54 thawed, cryopreserved teeth. In each group, 18 bonds were performed in superficial dentin, 18 in mid-coronal, and 18 in deep dentin. A resin composite cylinder, 3 mm in diameter and in height, was bonded orthogonally to the surface. After storage in distilled water at room temperature for 1 wk, the bonded cylinders underwent shear testing at a crosshead speed of 0.5 mm min-1. The mean remaining dentin thickness was calculated after longitudinally sectioning the debonded samples through the center of the bonded area. Non-parametric statistical analyses were used to correlate the shear bond strength with the remaining dentin thickness among the storage modes and within the different dentin regions. RESULTS: The lowest shear bond strength values were found in the deep dentin of both fresh and cryopreserved dentin, while the values in deep and mid-coronal dentin were not significantly different in fresh and cryopreserved dentin. In the superficial and mid-coronal dentin of cryopreserved samples, the shear bond strength values were identical. There was a significant difference between the shear bond strength values in the superficial dentin of fresh teeth compared to the values for cryopreserved teeth. SIGNIFICANCE: According to the experimental conditions, tooth cryopreservation shows some promise as a substitute for freshly extracted teeth, provided that the experiments are performed in midcoronal and deep dentin.

Composite Resins↗

Regional measurement of resin-dentin bonding as an array.

During the development of the microtensile bond-testing method, large variations in bond strengths were noted among serial sections. The reason for these variations is unknown. The purpose of this work was to determine the consistency of resin-dentin bond strengths across the occlusal surface of coronal dentin by dividing composite resin buildups into an array of 1x1 mm beams, the top half consisting of composite resin, and the bottom half consisting of dentin. Extracted human third molars had the occlusal enamel removed as a single section by means of a diamond saw. Resin composite buildups were made after the dentin was bonded with either One-Step or MacBond. After being stored in 37 degrees C water for 1 day, the teeth were vertically sectioned at 1-mm increments into slabs of bonded teeth. Each slab was further subdivided by vertical sections into 1x1x8 mm beams. Each beam was assigned an x-y coordinate and tested for tensile bond strength. Two different clinicians (A and B) performed the same procedures using One-Step in a parallel study. Using One-Step, clinician A obtained a large number of zero bonds in superficial dentin but fewer in deep dentin. This resulted in a very large standard deviation in bond strengths (mean +/- SD of 22+/-20 MPa in superficial dentin and 27+/-14 MPa in deep dentin). Clinician B obtained much higher (p<0.001) and more uniform bond strengths with One-Step (56+/-13 MPa in superficial dentin and 57+/-12 MPa in deep dentin). With MacBond, there were no zero bonds and hence less variation, with a mean of 41+/-13 MPa in superficial dentin and 27+/-12 MPa (x +/- SD) in deep dentin. When pairs of Z100 resin composite cylinders were bonded together with One-Step and then sectioned into an array, there was little variation in regional bond strength (37 +/-1 MPa). Dividing bonded resin composite buildups into an array of 20 to 30 1x1x8 mm beams allows for the evaluation of uniformity of resin-dentin bonds. The method used in this study detected local regional differences in resin-dentin bond strengths. The largest differences were shown to be related to technique rather than to material. The results indicate that resin-dentin bonds may not be as homogenous as was previously thought.

Adhesiveness↗

Effect of Er:YAG laser irradiation on acid resistance to bovine dentin in vitro.

Resin bond strength to Er:YAG laser irradiated dentin has been reported to be lower than that of unlased dentin. The reasons have been much discussed, but not clarified. One hypothetical cause has been discussed that lased dentin is acid resistant, therefore, the etching effect of acid conditions decreases. The purpose of this study was to evaluate the acid resistance of laser-irradiated dentin and compare it with the dissolved mineral of Er:YAG laser irradiated dentin and unlased dentin. This experiment was a pilot study to assess the etching effect of pre-conditioner for resin bonding to lased dentin. Bovine dentin was irradiated by Er:YAG laser and immersed in 0.1 M lactic buffer solution (pH 4.0). The dissolved Ca and P in the solution were then both measured. Dissolved Ca from lased dentin was not significantly different from that coming from unlased dentin (p > 0.05). The molar ratio of Ca/P did not differ significantly between lased and unlased dentin, either (p > 0.05). Under FE-SEM view before immersion, the dentin surface was covered with a smear layer in unlased dentin, but this layer was not clearly observed in lased dentin. These results suggested that the lased dentin had little or no resistance to lactic buffer solution.

Acid Etching, Dental↗

Resin adhesion to carious dentin.

PURPOSE: To investigate the microtensile bond strength (microTBS) of a self-etching priming adhesive system to normal, caries-affected and caries-infected dentin, and to observe the ultrastructure of the resin-dentin interface by transmission electron microscopy (TEM). MATERIALS AND METHODS: Twelve extracted human molar teeth with deep occlusal caries were stained with caries detector solution and ground flat occlusally. The red-stained soft dentin was classified as caries-infected. The surrounding discolored dentin was classified as caries-affected dentin. The surrounding normal dentin served as a control. The entire flat surface was bonded with Clearfil Liner Bond 2V (CV) and covered with resin composite to form a composite crown 5 mm high. One day later the specimens were serially sectioned vertically into multiple slabs 0.8 mm thick. Under microscopic observation, the specimens were divided into normal or caries-infected or caries-affected dentin. These regions were isolated by cutting away the remaining dentin to form hour-glass shapes with the smallest surface area at the test site. After measuring the areas, the specimens were fixed to a microtensile tester and pulled under tension to failure. Additional slabs that were not used for bond strength tests were processed for TEM. Bond strength data were analyzed by Kruskal-Wallis one-way ANOVA and Student-Newman-Keuls multiple comparisons. RESULTS: The microTBS of CV to normal, caries-affected and caries-infected dentin were 45 +/- 10 MPa, 30 +/- 10 MPa, 10 +/- 5 MPa, respectively. TEM images showed that CV formed thin hybrid layers that were less than 1 microm thick in normal dentin, but that were between 6-8 microm thick in caries-affected dentin. Bacteria were only sparsely observed in the dentin tubules of bonded caries-affected dentin. However, in caries-infected dentin, an unusual interface was seen in which carious bacteria within disorganized non-banded collagen fibrils could be seen embedded by the adhesive. The hybrid layer in caries-infected dentin was found to be 30-60 microm thick.

Acid Etching, Dental↗

Dentin-predentin complex and its permeability: physiologic overview.

The major channels for solute diffusion across dentin are the dentinal tubules. Since dentin permeation is proportional to the product of tubule number and diameter, both of which increase as the tubules converge on the pulp, we find that dentin permeability increases rapidly as the pulp chamber is approached. The presence of a smear layer of cutting debris on top of cut dentin decreases dentin permeability, especially when permeability is measured by fluid filtration. Further, intratubular material--such as mineral deposits, collagen fibrils, proteoglycan linings, bacteria, etc.--can greatly reduce dentin permeability. Although the presence of irregular or irritation dentin has been thought to greatly reduce dentin permeability, recent in vivo experiments in dogs indicate that the dentin permeability of freshly cut cavities prepared in sound dentin falls very rapidly (i.e., 50-60% in the first six hours) before any histologic changes can be detected, either in the pulp or the dentin. When dogs were depleted of their plasma fibrinogen, this rapid decline in dentin permeability following cavity preparation failed to take place. The results implicate leakage of plasma proteins from the underlying pulpal vessels. The proteins subsequently permeate the tubules, where they are either adsorbed to the tubule walls or physically trapped in such a way as to reduce dentin permeability.

Animals↗

Development of sensory innervation in dentin.

We have labeled dental nerves of 3-week- to 1-year-old rats by axonal transport of radioactive protein in order to detect nerves in developing dentin by autoradiography. We found that, in addition to nerve growth, two processes determine adult dentinal nerve location: (1) enclosure of nerves within circumpulpal dentinal tubules during the last few weeks of dentinogenesis, beginning at the tip of the pulp horn and spreading to include most coronal dentin; and (2) gradual loss of the nerves near the tip of the cusp because of dentinal attrition and replacement by noninnervated, reparative dentin. Several days before a molar erupts, nerves at the tip of the cusp have already begun to be enclosed by dentin; 2-3 weeks later, when dentinogenesis at the cusp tip slows down, most of the innervation for that region has been established, nerves extend up to 160 micron into dentin, and the molar has reached the stage of functional occlusion. Soon after initial occlusion, the process of dentinal attrition and replacement by noninnervated reparative dentin begins; however, simultaneous dentinogenesis in more apical regions produces new innervated dentin. We studied nerve position in relation to dentin growth lines and found that there is a long-term association of nerve endings with specific sites in the dentinal tubules. The similarities between the development of dentinal innervation in rat molars and in human permanent teeth are discussed; it is found that as teeth mature and become more sensitive to painful stimuli, the density of dentinal nerves increases.

Aging↗

Traumatic root resorption in dentine-immunized mice.

Traumatic root resorption in a mouse model has been shown to coincide with a decline in naturally occurring serum antibody levels to dentin. It has been proposed that root resorption may be dentin antibody mediated. The purpose of this study was to examine the traumatic root resorption response in mice after hyperimmunization with a crude tooth extract (dentin). The hypothesis of this study was that elevated dentin antibody titers would positively correlate with root resorption. Mice were immunized with mouse dentin and controls were sham immunized. All mice were boosted 4 weeks later with or without mouse dentin as appropriate. All mice were then boosted two more times at weekly intervals with mouse dentin and then twice at weekly intervals with rat dentin. The change to rat dentin was made to increase mouse serum antibody titers to dentin. Serum samples were obtained before the initial immunization and weekly after each boost and were examined for antibody-to-dentin antigen by the enzyme-linked immune sorbent assay (ELISA). One week after the second boost with rat dentin, all animals were exposed to the cryoprobe procedure. Mice were killed 10 days later, and serum tested for antibody to dentin antigen. The incisors were examined by scanning electron microscopy, and root resorption quantified. Root resorption was observed on the incisors in the sham-immunized mice but not in the dentin-immunized mice. A trend toward increased serum antibody titers to dentin in immunized mice was observed over time.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Reactivation of inactivated endogenous proteolytic activities in phosphoric acid-etched dentine by etch-and-rinse adhesives.

Auto-degradation of collagen matrices occurs in resin-infiltrated dentine by the slow action of host-derived matrix metalloproteinases. As phosphoric acid-etching inactivates these endogenous enzymes, it is puzzling how hybrid layers created by simplified etch-and-rinse adhesives can degrade in vivo. This study tested the null hypothesis that there are no differences in the relative proteolytic activities of mineralised dentine, acid-etched dentine, and etch-and-rinse adhesive-treated acid-etched dentine. Powdered dentine prepared from extracted human teeth was treated with 17% EDTA, 10% phosphoric acid, or with five simplified etch-and-rinse adhesives that were applied to 10% phosphoric acid-etched dentine. The gelatinolytic activity of the dentine powder was assayed using fluorescein-labelled gelatine. TEM examination of the air-dried, treated dentine powder was performed to confirm the presence of remnant mineralised dentine after acid-etching. 17% EDTA significantly reduced the relative proteolytic activity (73.2%) of the untreated mineralised dentine powder (control), while 10% phosphoric acid-etched dentine exhibited the highest reduction (98.1%). Treating the acid-etched dentine powder with any of the five simplified etch-and-rinse adhesives resulted in the reactivation of the proteolytic activity, with a significant negative linear correlation (P<0.05) between the increases in fluorescence and the corresponding pH values of the adhesives. It is concluded that simplified etch-and-rinse adhesives can reactivate endogenous enzymatic activities in dentine that are previously inactivated by phosphoric acid-etching. The amount of enzyme reactivated may even exceed the original quantity present in untreated mineralised dentine. This provides an explanation for the degradation of hybrid layers after acid-etched dentine matrices are infiltrated with these adhesives.

Dentin↗

Microtensile bond strength of glass ionomer cements to artificially created carious dentin.

In this laboratory study, the microtensile bond strengths of a conventional glass ionomer cement (GIC) and a resin modified glass ionomer cement (CRMGIC) to artificially created carious dentin and sound dentin were compared, and the ultrastructural morphology of the fractured interface was examined with a low-vacuum scanning electron microscope (SEM). The specimens were divided into 4 groups: 1) a conventional GIC (Ketac-Fil Plus Aplicap) placed on sound dentin; 2) a conventional GIC placed on artificially created carious dentin; 3) an RMGIC (Photac-Fil Aplicap) placed on sound dentin and 4) an RMGIC placed on artificially created carious dentin. Artificial carious lesions were created using a chemical demineralizing solution of 0.1 M/L lactic acid and 0.2% carbopol. GIC buildups were made on the dentin surfaces according to the manufacturer's directions. After storage in distilled water at 37 degrees C for 24 hours, the teeth were sectioned vertically into 1 x 1 x 8-mm beams for the microtensile bond strength test. The microtensile bond strength of each specimen was measured, and failure mode was determined using an optical microscope (40x). The fractured surfaces were further examined with SEM. Two-way analysis of variance showed that the mean microtensile bond strengths of a GIC and an RMGIC to carious dentin were significantly lower than those to sound dentin, and the mean microtensile bond strengths of Photac-Fil to both sound and carious dentin were significantly higher than those of Ketac-Fil Plus. Chi-square tests indicated that there was a significant difference in failure mode between the sound dentin and carious dentin groups. In sound dentin groups, cohesive failure in GIC was pre- dominant; whereas, mixed failure was predominant in carious dentin groups. SEM examination showed that the specimens determined to be cohesive failures under light microscopy in the Photac-Fil/Sound Dentin group were actually mixed failures under high magnification of SEM.

Adhesiveness↗

Buffering action of human dentin in vitro.

PURPOSE: The purpose of this study was to determine the relative contributions of the mineral and organic phases of dentin to its total buffering capacity and to compare the buffering abilities of normal and caries-affected dentin for acids used in adhesive dentistry. MATERIALS AND METHODS: Disks of normal and caries-affected human coronal dentin 0.6 mm thick were prepared. Fifty microL of various acids were applied to the surface of mineralized or completely demineralized dentin for varying lengths of time. They were collected from the surface and combined with water rinses to permit titration of the total amount of acid applied, the amount recovered, the total amount that was taken up by the dentin, and the amount that diffused across dentin into 1 mL of water. Equal volumes of acids were applied to mineralized or demineralized dentin powder or hydroxyapatite powder. RESULTS: About 88% to 90% of applied acid was recovered from the surface; only 10% to 12% of the acid was taken up by dentin. Of the H+ that was taken up, only 1% to 2% actually diffused across 0.6 mm of dentin. Increasing the application time of 37% phosphoric acid did not increase the amount of H+ that diffused across dentin. Increasing the concentration of phosphoric acid from 10% to 65% produced only slight increases in H+ diffusion across dentin. There was no difference in the buffering capacity of normal vs caries-affected dentin disks. Almost all of the buffering capacity of dentin is due to its mineral phase. CONCLUSION: The high buffering capacity of dentin and the high reactivity of H+ insure that little H+ diffuses through dentin more than 0.6 mm thick.

Analysis of Variance↗

[Determination of content and type of zinc binding in dentine after application of ZOE paste].

The article deals with the determination of zinc content in dentine after ZOE paste application as well as the investigation of the morphology ant morphological dentine changes caused by the paste action. The obtained data for the content of zinc in various dentine layers have shown that a marked zinc content elevation comparing to the natural content occurred only in the layers of which ZOE paste was directly applied. In anatomically deeper dentine layers (under ZOE paste), the content of zinc corresponded to the natural dentine level. On the basis of data obtained, it was concluded that during ZOE paste application no concomitant zinc diffusion occurred through the tooth tissue, but only zinc content was elevated in the dentine contact layer. However, on the basis of these data it was not possible to conclude weather chemical changes in the contact paste-dentine layer occurred or it made only a strong mechanical effect of paste on dentine adhesion. The investigation of dentine morphology which was removed by grinding (by mean used in dentistry practice) showed that this way of preparing the specimens caused the natural dentine structural alterations. By grinding dentine topography was completely affected. Very deep lesions and visible augmentation of the contact dentine surface that facilitated ZOE paste adhesion, occurred. Thus the permanent ZOE paste attachment to dentine occurred and dentine free energy decreased. In this way permanent adhesion of cement for dentine was impossible with negative consequences for the final therapy.

Dentin↗

Scanning electron microscopy of dentin caries. Experimental in vitro studies with Streptococcus mutans.

This study was performed to gain better insight into the mechanisms involved in carious destruction of human dentin by Streptococcus mutans. In particular, bacterial colonization of dentin surfaces and bacterial invasion in dentin were studied. Streptococcus mutans (S. mutans), strain NCTC 10449, was grown on sterile dentin blocks in a 10% CO2 atmosphere at 37 degrees C. After 72, 120, 144 and 288 h of incubation the specimens were processed for scanning electron microscopic examination. The colonization of the dentinal surface progressed slowly and was nearly complete after 288 h. Invasion of S. mutans into the dentinal tubules was found occasionally and was limited to the initial 5 micron of the tubular lumen. The acid metabolites produced by S. mutans, caused lesions of the dentinal structures in the close proximity of the bacteria. From the results of this in vitro study it appears that carious destruction of exposed dentinal surfaces by S. mutans mainly occurs at the exposed dentin after it has been colonized by bacteria. Destruction of the deeper dentinal layers by bacteria invading the dentinal tubules may play a less important role. However, in the few cases where S. mutans invaded the dentinal tubules, rapid destruction of the peritubular dentin sheath occurred. In addition, the possibility remains that acid metabolites produced by S. mutans diffuse into the dentinal tubules and cause tissue damage in the deeper parts of the dentin.

Dental Caries↗

What is the clinical relevance of in vitro dentine permeability tests?

This paper reviews the effect of dentine permeability on the bond strength of dentinal bonding systems and its relationship with the morphology of dentine. Deep dentine is more permeable than superficial dentine. Demineralization of dentine surfaces with acidic conditioners significantly increases permeability with respect to dentine covered by a smear layer. Several primers apparently leave intact smear layers as seen by scanning electron microscopy, but greatly increase the fluid filtration towards the dentine suggesting several modifications in the smear layer. Previous generations of dentinal bonding systems have been shown to be extremely sensitive to dentine humidity and permeability. By contrast, contemporary dentine bonding systems are not influenced by wet dentine. According to the Poiseuille-Hagen equation, small changes in the functional diameter of dentinal tubules can greatly modify permeability. Restorative materials are able to reduce the permeability of prepared dentine subject to location.

Dental Bonding↗

Dentine permeability and bond quality as affected by new bonding systems.

OBJECTIVES AND METHODS: The relationship between dentine bonding and the condition of dentine for four dentine bonding systems (All Bond 2, Clearfil Liner Bond, Scotchbond MP and XR Bond) has been examined. Different dentine conditions were evaluated and correlated with adhesion values. Dentine permeability was calculated using a hydraulic pressure apparatus working under physiological pulpal pressure (6.9 kPa), while remaining dentine thickness (RDT) was measured using pincer calipers. Scanning electron microscopic (SEM) examinations were effected to analyse dentine morphology. These evaluations were considered as an index of the condition of dentine. Shear bond strength tests were used to evaluate adhesion. Dentine samples after the bonding systems application were stored for 24 h under pulpal pressure before bond strength was tested. RESULTS: Scanning electron microscopy examinations indicated that the application of bonding system conditioners caused the removal of smear layer, the demineralization of dentine and the formation of a layer of collapsed collagen fibrils in the intertubular and peritubular dentine. Primers were able to infiltrate the collagen fibrils. A layer of resin infiltrated/reinforced dentine (the so-called 'hybrid layer') was observed for All Bond 2, Clearfil Linear Bond and Schotchbond MP. CONCLUSIONS: Significant correlations were observed only for XR Bond, which proved very sensitive to RDT and dentine permeability despite the presence of smear layer. The other three materials did not show any correlation with dentine conditions. By contrast they showed the highest bond values.

Acid Etching, Dental↗

Effect of a sodium hypochlorite gel on dentin bonding.

UNLABELLED: It has been suggested that the hybrid layer (HL) does not play any important role in the mechanism of adhesion to dentin. To substantiate this hypothetical insignificance of the HL, sodium hypochlorite (NaOCl) has been used to remove collagen from etched dentin prior to bonding. OBJECTIVES: The present study was conducted to determine the effect of a commercial 10% NaOCl gel on the dentin shear bond strengths and HL ultra-morphology of two simplified dentin adhesives. The null hypothesis tested was that treatment of etched dentin collagen with NaOCl would not compromise dentin bonding. METHODS: The labial surface of eighty bovine incisors was polished to expose middle dentin. The specimens were randomly assigned to two total-etch adhesive systems (N = 40): Prime&Bond NT (Dentsply Caulk); and Single Bond (3M Dental Products Division). After rinsing off the etchant, one drop of 10% NaOCl (AD Gel, Kuraray Ltd.) was applied to the etched dentin surface and left for 0 (control), 15, 30, or 60 s. The gel was rinsed off with water and the dentin surface kept visibly moist prior to the application of the adhesive as per manufacturer's instructions. The respective composite resin was subsequently applied and light-cured. After 24 h in water at 37 degrees C, the specimens were thermocycled for 500 cycles in baths kept at 5 and 55 degrees C and the shear bond strengths measured. The data were analyzed with two-way ANOVA. For TEM, sixteen dentin disks were taken from middle dentin of extracted human third molars, assigned to the eight treatment sequences, and observed. RESULTS: The increase in the NaOCl application time resulted in a progressive decrease in shear bond strengths for both dentin adhesives. For Single Bond, the application of AD Gel for 60 s resulted in a reduction of bond strengths to 38% of that obtained for the control. For Prime&Bond NT, the mean bond strength obtained when AD Gel was applied for 60 s was 31% of that obtained for the control. The application of AD Gel resulted in distinct morphology for each one of the two adhesives tested. For Single Bond, the general morphology of the collagen network was maintained, regardless of the deproteinization time. The interfibrillar space within the collagen network increased with increasing deproteinization times. For Prime&Bond NT, the general appearance of the HL was maintained for deproteinization times of 15 and 30 s. When the NaOCl gel was applied for 60 s, the morphological appearance of the HL lost its fibrillar arrangement. While remnants of the collagen fibers were observed in one of the dentin disks, the other specimen showed an amorphous structure without any discernible HL morphological features. SIGNIFICANCE: The integrity of the collagen fibrils left exposed upon acid-etching plays a major role in the mechanism of adhesion of the specific adhesive systems tested in this study. The intermingling of the adhesive monomers with the filigree of collagen fibers or HL should still be considered the paramount dentin bonding mechanism.

Acid Etching, Dental↗

Ultrastructure of hypersensitive and non-sensitive dentine. A study on replica models.

Patients with cervical dentine exposures do not always complain of dentine hypersensitivity. The identification of morphological features connected to symptoms is important for both prevention and management of dentine hypersensitivity. The aim of the study was to determine the relationship between the dentine ultrastructure and clinical symptoms in patients with cervical dentine exposures. Replica models for a total of 28 teeth (from 10 patients) with cervical non caroius lesions and dentine exposures were obtained before and after acid etching. The replica models were studied blindly in the scanning electron microscope (SEM). 12 of these were classified clinically as hypersensitive and 16 as non-sensitive. Because of the morphological heterogeneity of all specimens, a grid was used to isolate smaller, more homogeneous areas. 120 (75 non-sensitive and 45 hypersensitive areas) grid areas randomly selected from the 28 dentine surfaces were analyzed. The presence and morphology (amorphous or crystalline) of smear layers and the density and diameter of dentine tubules were recorded. The chi 2 test was used for statistical analysis. In unetched specimens, the surfaces classified as non-sensitive were frequently coated by an amorphous smear layer (88.0%) and occasionally by a crystalline smear layer (2.7%). Only a few and narrow tubules were observed (9.3%). On the other hand, the unetched specimens of the hypersensitive dentine exhibited less frequently (31.3%) an amorphous smear layer. The presence of crystalline smear layer (33.3%), many and wider patent tubules and, sometimes, loss of intertubular dentine manifested as grooves between tubules, were observed (35.6%). The differences were significant (p < .001). In hypersensitive dentine, the acid etching always removed the smear layer whereas removal in non-sensitive dentine was partial or absent. These morphological findings underline the rôle of smear layer in reducing permeability of dentine in patients with dentine sensitivity.

Acid Etching, Dental↗